Mary C Lane

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

155277 Issued in TX

Practice address

11049 W Hoffman Dr
Odessa, TX 79764-9043

Phone

(432) 385-7790

NPI assigned

Feb 19, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1508366238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2613 NEILL RD # 6C",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797200413",
            "telephone_number": "817-401-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11049 W HOFFMAN DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797649043",
            "telephone_number": "432-385-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "MARY",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "155277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yohanny Saraith Laguna Joa
• Brian P Lake, PHARM D
• Becky Lamb, LPN
• Courtney Lambert
• Mindi Lambert
• Jarrett Lange, PT
• Lawrence David Lassa, O.D.
• Alicia Marie Latraille
• Dayna Lavallee
• Modinat Abolore Lawal

• Licensed Vocational Nurse in Odessa, TX
• Providers in Odessa, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.